Dosimetric Comparison between 3D-Conformal Radiotherapy and Volumetric Modulated Arc Therapy for the Heart in Left- Sided Breast Irradiation | ||
| SECI Oncology Journal | ||
| Volume 13, Issue 4, October 2025, Pages 326-335 PDF (697.83 K) | ||
| DOI: 10.21608/secioj.2025.465421 | ||
| Abstract | ||
| Background: After breast-conserving surgery, irradiation to whole breast lowers the rate of recurrence. Deep inspiration breath-hold technique is the most effective way to lower radiation doses to the heart and if it is not accessible, alternative options like intensity-modulated radiation therapy (IMRT), volumetric modulated arc therapy (VMAT) or three-dimensional conformal radiation therapy(3D-CRT) must be chosen. We aimed for comparing the dosimetric measurements affecting the target and organs-at-risk (OAR) in VMAT+SIB and 3D-CRT+SIB. Methods: A comprehensive sample of 54 were included in the study. Patients were allocated into 2 Arms, arm A received 3D-CRT+SIB, arm B received VMAT+SIB, each arm received WBI 40 Gy/15 fractions with SIB 8 Gy/15 fractions. Comparison of both arms, treatment plans evaluation, Dose Volume Histograms especially dose constrains to heart and coronary artery, target dose coverage, conformity index, monitor units’ number and homogeneity index were analyzed. Results: A significant difference between two groups was seen regarding to target coverage dosimetry. VMAT demonstrated higher mean CTV than 3D- CRT. Also, a significant difference was noted regarding OAR dosimetry, as the VMAT was associated with higher doses to the heart, right lung, and right breast. In contrast, the 3D-CRT delivered a higher minimum, maximum and mean left anterior descending coronary artery (LAD) doses. The VMAT demonstrated significantly higher CI and MU but HI among both groups did not differ significantly. Conclusion: multi-fields and arcs arrangements (VMAT) considerably decreased the doses to the LAD and improved doses to the target, although approaches with tangential fields arrangement (3DCRT) provided better OARs dosimetry. | ||
| Keywords | ||
| Left breast cancer; irradiation; 3D-CRT; VMAT; dosimetry | ||
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